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Knee: Ruptured Ligament and Meniscus

Last year my knee exploded while during a heel hook. I ruptured my lateral collateral ligament, tore my posterior cruciate and arcuate ligament, the medial meniscus, as well as disrupting the posterior capsule of the knee joint. How is it even possible to do so much damage? My knee feels fine now but I can’t really do the same things with it.

Tilly Parkins | Sydney, Australia

If Mother Nature did not have a biological monopoly, and evolution existed in the free market, knees would be better designed and come with a 100,000-mile or 50-year warranty.

Centuries ago the peripatetic knee was an admirable joint, and teeth were our weakest link. As grades go up, and climbers come down … harder, so does the stress and strain. Knees are placed in positions of extreme torsion while climbing and, as the new-age-bravado-boulder problem becomes the norm (i.e., a short route sans rope) they are suffering considerably more from sudden loading.

Like the shoulder, the knee has a nasty propensity to cascade through multiple injuries in an instant. When one ligament ruptures it shock loads the next, and so on. The pathomechanics are complicated, but it is certainly not uncommon to do several other injuries as the force is taken up elsewhere.

A year down the track and a marathon of rehab behind you, your knee should be in tip-top shape. I suspect your head is not, however, and that you live in fear of hearing the nauseating sound of tearing flesh and connective tissue.

You could broach these issues with Dr. Phil, but I think you would have more success with Dr. Google. There are lots of sports psychology books that deal with returning from injury. A few ideas: A) strength is a great catalyst of confidence; go to the gym, do yoga, tantric pole dance, whatever it takes for you to think that knee is just like the other one. B) Imagine you are a heel-hooking Transformer. C) Set some route goals that will progressively test your knee.

Certainly there will be some restrictions in the knee associated with both the injured tissue and the immobilization following surgery. It sounds like you have moved through most of this already and your surgeon and P.T. have clearly done a good job. Run that knee through some hoops. If it’s not hurting add some fire and music, and dance up a storm. One simple rule—pay attention! A little pain is fine as long as it does not last for days. When you catch yourself wondering which knee it was, you are free to try the magnum opus of tantric pole dancing—the one-legged-upside-down-starfish. Good luck.

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